• Anxiety and mood
• /
• v.14 no.1
• /
• pp.44-52
• /
• 2018

Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

• Korean Journal of Psychosomatic Medicine
• /
• v.28 no.1
• /
• pp.53-62
• /
• 2020

Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.7 no.2
• /
• pp.114-119
• /
• 2007

Background: Dental disabilities mean the poor cooperation for dental treatment because of patient's inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely. Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients' dental charts and sedation records were retrospectively reviewed. Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 ${\pm}$ 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 ${\pm}$ 12.3 min and that of sedation was 43.2 ${\pm}$ 9.7 min. Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients' disabilities, and the experience of dental anesthesiologists altogether.

• Journal of Korean Academy of Nursing
• /
• v.25 no.3
• /
• pp.399-418
• /
• 1995

The purpose of this study was to investigate the stress response of nurses working on psychiatric wards (psychiatric nurses) compared with that of nurses working on general wards (general nurses) in order to provide assessment data for intervention of the stress response. The Symptoms of Stress Inventory was used to measure the stress response. Data were collected by a direct survey method using a questionnaire and were collected from March first to March 30, 1995. A sample of 200 nurses working in three psychiatric hospitals and psychiatric wards in four university hospitals in Seoul and Kangwon province were selected and 200 nurses working on general wards from two general hospitals in Seoul were also selected for a total sample of 400 nurses. Nurses who had experienced more than one of the major life events in the last two years were excluded from the total number in the samples, so the final sample was 161 psychiatric nurses, and 169 general nurses. The Scores for the total stress response, scores of the SOS subscales, stress response by sociodemographic characteristics of the nurses working on the psychiatric wards were compared with those of nurses working on the general ward. The results of this investigation are as follows 1. The mean total SOS score for the psychiatric nurse was 0.81 (SD=0.48) and that of the general nurses was 0.90(SD=0.53). 2. The Mean score for peripheral manifestation, con tral-neurological symptoms, gastrointestinal symptoms, muscle tension, habitual patterns, de-pression, anxiety, anger and cognitive disorganization for the general nurses showed a tendency to be higher than those of the psychiatric nurses. Mean score for cardiopulmonary symptoms for the general nurses was significantly higher than that of the psychiatric nurses. 3. The mean scores for the sixteen SOS items for the general nurses was significantly higher than for the psychiatric nurses. The 16 items were flushing of the face, sweating excessively even in cold weather, thumping of the heart, rapid breathing, dry mouth, a choking lump in the throat, hoarseness, muscle tension in hands or arm, muscle tension in leg, working tiring one out completely, severe aches a핀 Pain make it diffi-cult to do the work, severe nervous exhaustion, worrying about health, feeling weak and faint, so upset that one wants to hit something, unable to keep thoughts from running through one's mind. The mean score of only 505 item were significantly higher for the psychiatric nurses. 4. Stress responses between psychiatric nurses and general nurses were significantly different according to the following demographic characteristics : marriage, duration of work, position, accommodation, planning to move into another working site, working ward, education in psychiatric nursing.

• Journal of Korean Academy of Nursing
• /
• v.26 no.2
• /
• pp.290-303
• /
• 1996

There is a need to define the concept of suffering more appropriate in the context of Korean culture. This research is an attempt to analyze and develop the concept of suffering by applying the Hybrid Model suggested by Schwartz-Barcott and Kim. The data were collected from March 20, 1995 to September 17,1995. The subjects of the study were eight persons including in-patients and out-patients of a general hospital who were diagnosed as having cancer and those resting in sanatoria for natural treatment of cancer. Qualitative research methods of in-depth interview and participant observation were used for data collection. The contents of the interviews were recorded on tape. Data-analysis progressed according to the 3 phases suggested by the Hybrid Model. For each case, in-depth interview data and participant observation data were included and the attributes of suffering revealed in these data were analyzed. Finally, by summarizing the results from each case, the attributes of suffering, its dimensions, definition, and processes observed in the field were suggested. According to the results of the study, the followlng new definition of suffering is suggested : Suffering is a fundamental and inevitable experience of all human beings. When each individual experiences loss, damage, and pain which threaten one's personal integrity, suffering is perceived differently among each individual depending on their personal inner factors, one's significant others, exterior circumstances and stimuli, and the ultimate meaning of life. Suffering brings severe and unendurable distress which accompany despair, powerlessness, anxiety, bitterness, fear, anguish, guilt, depression, withdrawal and anger. The results of this study suggest that the more responsibility and burden a cancer patient felt, the more suffering she/he experienced and it tended to be more relevant to one's significant others and exterior circumstances and stimuli : the less responsibility and burden a cancer patient had, the less suffering she/he experienced and it tended to be related to one's inner factors. These findings have implications for nursing profession. When caring for patients who experience suffering, nurses need to consider the influence of responsibility, burden, and each dimension of suffering. Moreover, appropriate nursing interventions aimed at relieving pain and satisfying the spiritual need of patients experiencing loss need to be developed and implemented more widely.

• Korean Journal of Biological Psychiatry
• /
• v.18 no.3
• /
• pp.109-118
• /
• 2011

Objectives Many studies have suggested different neurobiological findings and clinical courses in alcoholism. Recently, subtyping in alcohol dependence has become essential to overcome the heterogeneity of patients. Among several criteria of subtypes, Lesch's typology is proposed to integrate biological, social, and psychological factors. This review provides neurobiological findings and treatment-responses of alcohol dependence according to Lesch's typology. Method We searched the international published medical literature using the search terms 'Lesch's typology' and 'alcohol dependence' and using the limits 'human'. Results We identified 17 studies with subjects of alcohol dependence according to Lesch's typology. Conclusion They indicated that each subtype of Lesch's typology can have specific neurobiological factors and different clinical responses as follows. Lesch's subtype 1 is characterized by severe withdrawal symptoms and associated with elevated glutamate and homocysteine. Lesch's subtype 2 is defined by individuals who drink alcohol as self-medication for anxiety. Their craving has significant positive correlations with prolactin, leptin level, or intake-volume (vasopressin). Lesch's subtype 4 is related to cerebral dysfunction and associated with increased glutamate and left-handedness. Clinical trials showed that naltrexone was effective in Lesch's subtype 3 and 4 patients, while acamprosate was effective in the subtypes 1 and 2.

• Journal of Oriental Neuropsychiatry
• /
• v.19 no.3
• /
• pp.35-44
• /
• 2008

Objective: There are many meditation methods used in clinical field. But the effect of meditation may be different to people's mind, and meditation itself. Now we investigate this subject with two different meditation methods which has been analyzed by heart rate variability. Method: We tried to check people's heart rate who educated meditation, before educated and during the meditation. The meditation was educated differently for each group. One is the auto genes traning, and the other is the imaginary meditation by thinking about eating and smelling favorite fruits. All of them are used to oriental psychiatry clinic patients. And we simultaneously conduct people's emotional state by SCL-90-R. Result: The result in Autogene traning group has significant difference in total power and HRV-index score between before and during the training but in imaginary meditation group has no significance: Autogene traning group has a significance in low frequency score and has increased tendency with increasing tendency of Heart rate index and Total power. Through the SCL-90-R score, the higher depression t-score, the anxiety t-score, and the hostility score is, the HRV scores such as total power, low frequency, and HRV-index much increase. and so on. Conclusion: We can guess that the Autogenes training has more significant effect than the imaginary meditation. And we can also guess that as the emotional problem is getting more severe, the effect of meditation would be much better. And we finally suggest that we should make a standard guideline of imaginary meditation, cause the imaginary meditation has so many variation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.6 no.1
• /
• pp.34-42
• /
• 1995

Borderline personality disorder in adolescents present with suicide attempts or gestures, and they are characterized by the same patterns of splitting, devaluation, manipulation, need-gratifying object relations, impulsivity, and ego deficits that are finds in borderline adults, Symptomatolgy are depression, anxiety, identity crisis, and occasionally antisocial behavior in borderline personality disorder in adolescents. These findings should be differentiated to normal stormy adolescents. Theses borderline personality disorder in adolescents are known about the instability of object relations, labile affect, splitting, and psychotic episode in severe stress. According to thses finding, schizophrenia, mood disorder, schizoptypal personality disorder, paranoid personality disorder could be differentiated. Etiology is complex including psychodynamic, genetic, familial factor. Treatments are individual psychotherapy, group therapy, and pharmacotherapy. The continuity or discontinuity of borderline states from childhoon to adult life is controversy.

• Journal of the Korea Convergence Society
• /
• v.11 no.10
• /
• pp.287-298
• /
• 2020

Air pollution is a severe risk factor in public health. It is not only a cause of a variety of physical disorders but also attributable to mental health problems. This study aimed to investigate the differences on emotions, physical symptoms, future perspectives by perceived air pollution. Sixty-one university students were randomly allocated either to air pollution group (n = 30) or clean air group (n = 31). Participants watched a news video clip of a polluted city or a clean city according to their condition and were asked to imagine as if they were living in the city. Results showed that air pollution group reported increased depression, anxiety, anger and physical symptoms after the exposure. Meanwhile, clean air group showed no significant changes or decrease of them. In addition, air pollution group reported restrained future time perspectives and decreased plan of outdoor activities, while clean air group did not report significant changes after the exposure.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.4
• /
• pp.486-492
• /
• 2001

Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.